Dr Kellner is Professor in the department of psychiatry at the Icahn School of Medicine at Mount Sinai; Chief of Geriatric Psychiatry for the Mount Sinai Health System; and Director of the ECT Service at the Mount Sinai Hospital in New York.
Simply telling patients “we don’t know how ECT works” neglects our abundant knowledge of what this treatment does. The authors review biological actions of ECT and discuss future directions for research.
This review covers recent advances in ECT technique, post-ECT management, and theories of mechanism of action. It will focus on the use of ECT in depression, the most common indication for ECT in clinical practice.
Some recent breakthroughs, using newly developed neuroscience investigational tools, suggest that if research resources are available, we could soon make substantial advances in understanding the mechanism of action of ECT.
Catatonia—a syndrome of disturbed motor, mood, and systemic signs (eg, rigidity, immobility, mutism, staring, posturing, waxy flexibility, echopraxia, echolalia, and stereotypies)—has led to the clarification of its appropriate treatment.